♪ oh baby i live ♪ [ cheering and applause ] this is "nightline." >> tonight, shedding the pounds. the skinny shot that's transforming thousands of lives. >> i knew that i felt like i was slowly dying, and i knew that i

had to make a change. i'm about 96 pounds down. >> everyone trying to get it. some turning to med spas. >> the demand was through the roof. we kept book all these consultations for weight management. >> but are they safe? >> people also need to understand that this is not a dyi situation. no prescription medication should be a dyi. >> and is going the med spa route as effective? plus world cup fever. team usa going for the three-peat. >> she has two, sophia smith. >> rookies proving they have the right stuff and fighting for equal pay in women's sports. >> we've kind of framed it as we're attacking this world cup. and, you know, it's not what you're defending, it's what there is to gain. >> and megan rapinoe, one of america's most iconic athletes prepares to call it a day. >> she is bold. she is brave. she is out front and she is doing it. she says stuff and she backs it

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good evening. thank you for joining us. it seems like everywhere we turn, people are slimming down from popular weight loss drugs like ozempic and mounjaro. but for some, increasing costs and decreasing availability has

them turning to alternatives like neighborhood med spas. but are they the answer and are they safe? here is abc's mona kosar abdi. >> we secured a backup plan. >> reporter: this is the moment that katelyn wade has been dreading. >> i am a little worried, but i am trusting in god, and i know my insurance won't approve mounjaro. i tried. i've had five denials. >> i'm following you. >> reporter: for the last ten months, katelyn has been taking mounjaro, one of the injectable drugs originally developed to treat type 2 diabetes, now being used for weight loss. >> i'm about 96 pounds down. >> reporter: she was desperate for a change, starting her journey at nearly 400 pounds. >> i could barely shower myself or get up the stairs a year ago. and look where i am now. you know, i never thought that that would be me. >> reporter: since starting mounjaro, it's been really working for her. katelyn started documenting or weight loss journey on social

media. but katelyn says her insurance won't cover mounjaro, and the manufacturer's coupon allowing her to pay $25 a month at the pharmacy expired in june. >> it was whole lot of things. anger, disappointment, worry, even with my obesity diagnosis, my pcos, having high blood pressure and high cholesterol, that still wasn't enough for my insurance to be approved for it. i've looked around my city for mounjaro, and it's about $1100 if i am trying to buy it without any coupons or insurance. >> reporter: so she made the decision to switch to another class of drugs that can also lead to weight loss. >> i had to find another option. >> reporter: katelyn is one of thousand whose lives have been transformed from drugs like mounjaro, and wegovy. >> they are game changers for the management of the conditions of overweight and obesity. what is new is the more

widespread or increasing acceptance of these tools in our tool box to help people who are living with obesity. >> reporter: everywhere you look, it seems like people are shedding pounds with these drugs. >> i can't make any promises. >> reporter: like real housewives of orange county star emily simpson. she spoke about trying ozempic on siriusxm's jeff lewis live. >> she actually said why don't you do ozempic. soy did. >> reporter: and in may, charles barkley says he lost almost 60 pounds on mounjaro, talking about it on the pat mcphee show. >> it's been great. i'm starting to feel like a human being, not a fat ass anymore. >> hell, yeah. >> i'm taking my shot once a week. >> reporter: it's positive results like this helping to fuel the demand for these drugs. but many insurance companies do not cover these medications for weight loss, leaving patients to foot the bill. >> they often are paying out of pocket, and the costs can be anywhere between a thousand to

$1500 a month. >> reporter: that out-of-pocket price leading some patients to find alternative solutions, turning to med spas and compounding pharmacies, offering patients the active ingredient in ozempic and wegovy. >> directly to your door. it's so nice. >> on instagram or on tiktok, i'll scroll by and see an ad for a weight loss clinic or somewhere in my area. that is going to be my second option if trulicity doesn't happen to work out for me. at that point, you're desperate, you know. >> reporter: tenth avenue aesthetics in long island is a fully licensed med spa that is owned and operated by practitioners. sylvia tut hillarhill is one of owners. >> we do injectables. >> reporter: but now it's moving into a bold new frontier, medical weight loss offering prescriptions for semiglutide. >> my business partner has a lot of experience in weight loss

management. i really feel comfortable bringing this to our practice. >> reporter: the first patient, sylvia herself. >> so we decided to use me as a little guinea pig. i wanted to make sure that everything was appropriate and well rounded before we launched it mainstream. >> reporter: you start offering this weight loss injectable drug. people ready to start and jump on the program? >> as soon as we launched it, the demand was through the roof. the phone wouldn't stop ringing because we kept on booking all these consultations for weight loss management. >> so we just received this shipment today. >> reporter: after screening and doing blood work on her patient, sylvia says she sends prescriptions for semiglutide to a compounding pharmacy to get filled. >> compounding pharmacies are pharmacies that are quite literally mixing or making their own formulations. there are reputable ones and disreputable ones. and unfortunately, it can be very difficult to tell which is which. and people also need to understand that this is not a

diy situation. no prescription medication should be a diy. so when you go to a compounding pharmacy, and you have no one to follow up with, if there is a problem, you're really on your own. >> reporter: the fda says while these drugs were eligible for compounding because of initial shortages, compounded drugs post a higher risk to patients than fda approved drugs because compounded drugs do not undergo fda premarket review for safety, effectiveness or quality. but sylvia stands by her practice of using those pharmacies. >> compounding pharmacies have been around for many years, and they're accredited. i think it's helpful for people who are out there that are dealing with being overweight or being uncomfortable with their own skin, because we're able to help them. >> reporter: for sylvia, that access means helping her patients achieve their goals. >> a lot of patients are having great success on this drug. so it's not something that we have to twist our patients' arm

for them to storm. they absolutely love the results. they love the safety profile, and they love the support that they get from the providers here in our practice as well. >> reporter: a monthly semiglutide plante will cost about $800. but on living social and groupon some are promoting deals for less than $100 a month. and particularly they show very slim women in bikinis. they just show, again, just very slim people. >> they're going to get flooded with patients that think that oh, they can come in and lose 10 pounds right before their wedding, and it will be fine. no, it's not safe for those individuals. so it's actually not responsible practice of medicine to advertise in this way. >> reporter: doctors gently don't recommend using these drugs just to shed a few pounds. common side effects include nausea and dehydration. the ozempic ads mention a few serious risks. >> serious side effects may

include pancreatitis, gallbladder problems may occur. >> reporter: the maker of wegovy and ozempic novo nordisk filed in five states and clinics who novo nordisk say are using false advertising, infringing on their trademark and selling products that claim to contain semaglutide. they cannot validate the safety or effective of products that are not one of their own branded products. one of the med spas getting sued flawless image say they combine eligible patients with compounded semaglutid base, adding we believe these lawsuits were filed against flawless image and other medical providers as a way to intimidate doctors against prescribing the semaglutide compound. >> if a patient elects to use a compounded form of the medicine,

we can't guarantee what's in the drug and we can't guarantee you'll see the expected results you would see with the actual fda-a proved product. >> reporter: tenth avenue aesthetics which is not being sued by novo north disk say they get their semaglutide from a compounding pharmacy they trust. >> there is a drug shortage and we're legally practicing within our means. but it's important for other med spas to be transparent in the drugs that they're offering, making sure that your patients know this is a compound version of semaglutide. >> while katelyn's fight continues, she is also reaching new milestones. >> we're going to fight for this medication because obesity is a disease, and we need to be treated just like everyone else. >> reporter: like the first time flying and having the seat belt fit. and competing in a beauty pageant, celebrating how far she has come. >> everyone was talking about how mounjaro will be approved by the end of the year because who

really knows how long that timeline is going to be. am i going to be another 100 pounds up again? in my mind, i want to fight to get healthy now. >> our thanks to mona. when we come back, we're with the american world cup team on the other side of the world as they try to make history. ♪ i know what you're thinking. this all-new nissan ariya can't be an electric vehicle. you can't possibly be powerful and polished. or be able to let go, and enjoy the open road. why choose when you can have it all? ♪ [stomach growling] it's nothing... sounds like something. ♪when you have nausea, heartburn, indigestion♪ ♪upset stomach, diarrhea♪

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rapinoe as they set their sights on their third straight victory. here is abc's maggie rulli from new zealand. >> here it is. goal! u.s. leads. >> reporter: they're back at it, tearing across the pitch. the u.s. women's soccer team on the cusp of making history at the world cup. >> the drought is over. the u.s. wins the 2015 women's world cup. >> after dominating in 2015 and again in 2019, this would be the first ever three-peat win, meaning three world cups in a row, something no women or men's team has ever been able to do. >> goal! >> so how do you deal with all that extra pressure, the extra weight of expectations? >> we've kind of framed it as we're attacking this world cup. and, you know, it's not what you're defending. it's what there is to gain. >> reporter: soccer super fans from around the world have made their way to australia and new

zealand. why was it important to you to bring your daughters halfway around the world just to see the u.s. women's soccer team play? >> well, they love playing soccer. and we watch a lot of soccer at home. and we just thought that this is the highest, highest level you can get to, and thought this would be a great opportunity for them to see the world, as well as to see their favorite players play live. >> reporter: they trekked all the way from portland, oregon. what did you guys think when your parents came to you and said listen, do you want to travel 15 hours on an airplane to go halfway around the world the watch soccer? >> i was really surprised. i didn't believe it at first. but, yeah, and then we did it, and i was really excited about it. >> reporter: aspires soccer stars themselves here to see their heroes. >> what do you think of the u.s. women's team? >> well, they're really good role models for us. >> reporter: who is your favorite player? >> sophia smith. >> reporter: who is your favorite player? >> sophia smith. >> reporter: both of you! why do you like sophia? >> she plays like me i'd say. >> reporter: what do you like

about sophia? >> she plays similar positions as me. so i look up to her and love watching her. she is just a really good player. >> reporter: 22-year-old colorado native sophia smith making her world cup debut in spectacular fashion, scoring two of the team's three goals in their first victory of the tourism against vietnam. >> she has two. sophia smith. >> it's always good to start off on a good note. and feeling confident, feeling good as a team, that's what we want going into these next few games. but especially the next one. >> reporter: the crowd absolutely erupted when two-time world cup winner megan rapinoe came in as a substitute in the second half. this was the soccer legend's 200th appearance for the u.s. team. >> it's very special being able to play in a world cup. it's very special knowing this will be my last with this incredible team. >> reporter: at 38 years old, rapinoe's gearing up for retirement. this is her fourth time playing in a world cup. she announced just weeks ago it will also be her last. >> i feel so honored to be able to have represented this country

and this federation for so many years. >> in victory and joy for the united states. >> reporter: she says what she means. she means what she says. she is not afraid. she is bold. she is brave. she is out front and she is doing it. and she says stuff and she backs it up. >> reporter: the team's epic winning streak isn't new, but some american viewers are just catching on. average viewership for the team's opener against vietnam nearly doubled from their kickoff match back in 2019. >> americans are starting to fall in love with the game that most of the country have been in love with for centuries in some cases. >> goal! >> reporter: since 1991, there have been eight women's world cups. the u.s. has won four of them, and they've never finished lower than third place. meanwhile, their male counterparts aren't on such a hot streak. they've never won a world cup. the last time they qualified for the quarterfinals was 2002. despite the glaring difference in their success, the women's team had historically been underpaid.

one 2020 report by the global players union found that across the board, top female players get paid the same or less in a year than what comparable male players make in a month. since 2019, the women's team had been fighting to close that gap. megan rapinoe later speaking out from the white house. >> and despite those wins, i've been devalued, i've been disrespected, and dismissed because i am a woman. >> reporter: after a three-year legal battle, members of the u.s. women's national team reached a $24 million settlement with the u.s. soccer federation, which agreed to pay men and women equally in future matches, including the world cup. >> i was thrilled. i honestly didn't think that we were going to be able to reach equity in my lifetime. and so it is legendary. it is a blockbuster deal. >> reporter: this team's often on the forefront of change. this year's usa roster is no different, now making history as the most diverse women's team of all time. what does it mean for you to be a part of this moment in history as well? >> it's amazing to me, because

now if a little kid that looks like me sees players that look like her, it means everything to them. so being able to look up to them and be like i want to be like her, i think that's really cool to have idols like that. >> reporter: in 1999, breanna scurry, a goalie was the first and only woman of color and the first openly gay woman on the u.s. team. >> so when i played in '99, for example, i take that team as ground zero, and the team now with all the players of color on it, with players that are openly gay on there now, the way that they get along well with each other, and fighting for the three-peat, which has never been done, it's a testament to what women can do together. i mean, there is only 23 players, and they are impacting the world as one. >> i think any time we can be that player that young athletes can look up to and see

themselves in, that's why we do it. that's why we play. >> reporter: has it sunk in for you yet that you used to watch the u.s. women's world cup team and they were your role models, and now you're those role models? >> like we knew that that's what comes with being on this team is you are -- you're an athlete. you're a soccer player, but you're so much more than that. >> reporter: for young girls around the world, these soccer players have become personal heroes. >> i know that when they're my age, they'll look back or maybe even sooner than that and be like wow, that was amazing that i got to see these incredible women who are changing history. >> byron: our thanks to maggie. up next, our own stephanie ramos takes her turn out the mic and knocks it out of the park. ♪ things are looking up ♪ ♪ i've got symptom relief ♪ ♪ control of my crohn's means everything to me. ♪ ♪ ♪ control is everything to me. ♪

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and finally tonight, our abc news colleague stephanie ramos is a woman of many talents. not only is she a bad ass veteran of the iraq war, she is an accomplished journalist, and she can really sing. ♪ god >> byron: stephanie belted out "god bless america" at the mets game. we can confidently say stephanie was a hit. ♪ >> byron: and she is as kind a person as she is talented. that's "nightline" for this evening. catch full episodes on hulu. we'll see you right back here same time tomorrow. thanks for the company, america. good night.